Background With China's socio-economic development, the dietary structure of Chinese residents has gradually shifted from a traditional Eastern pattern characterized by high carbohydrate intake to a relatively high-fat Western dietary model, alongside a growing burden of chronic diseases. However, dietary changes may vary across different occupational groups. Objective To analyze the long-term trends in dietary energy and three major macronutrient intake among various occupational groups aged 18-59 years in nine provinces of China from 1989 to 2018, providing a scientific basis for developing occupation-specific dietary intervention strategies. Methods Based on 11 waves of data (1989–2018) from the China Health and Nutrition Survey (CHNS), 57458 employed individuals aged 18-59 years were selected as observation subjects after applying inclusion and exclusion criteria. Joinpoint regression was used to analyze temporal trends by calculating the annual percentage change (APC) and average annual percentage change (AAPC) with 95% confidence intervals. The analysis covered the energy supply ratio from the three major macronutrients and the proportion of the participants within the acceptable macronutrient distribution ranges (AMDR) for the total occupational population and specific occupational group. Results From 1989 to 2018, the dietary structure of the occupational population in the nine provinces gradually Westernized. The carbohydrate energy supply ratio showed a decreasing trend (AAPC=−0.77%, 95%CI: −1.00%, −0.55%, P<0.05), while the fat energy supply ratio increased (AAPC=1.42%, 95%CI: 1.07%, 1.77%, P<0.05). The protein energy supply ratio remained largely unchanged (AAPC=−0.19%, 95%CI: −0.08%, 0.46%, P>0.05), and the total energy intake declined (AAPC=−0.62%, 95%CI: −0.94%, −0.30%, P<0.05). Among the occupational groups studied, white-collar workers were the first to show characteristics of dietary Westernization. Using the AMDR as the criterion, their average fat energy supply ratio first exceeded the AMDR upper limit (30%) in 1993, and their average carbohydrate energy supply ratio first fell below the AMDR lower limit (50%) in 2006, both time points being earlier than other occupational groups. Agricultural workers lagged in this transition (their average fat energy supply ratio first reached ≥30% in 2011), but their rate of increase in the fat energy supply ratio was the fastest among all occupational groups (AAPC=1.59%, 95%CI: 0.90%, 2.30%, P<0.05; P for trend comparison between groups<0.05). The other three occupational groups (blue-collar workers, service workers, and others) generally fell between these two extremes. Taking the fat energy supply ratio as an example, their AAPCs of increase were 1.02% (95%CI: 0.73%, 1.32%, P<0.05) for blue-collar workers, 0.85% (95%CI: 0.61%, 1.09%, P<0.05) for service workers, and 0.88% (95%CI: 0.58%, 1.17%, P<0.05) for others. Conclusion From 1989 to 2018, the macronutrient structure of the occupational population aged 18-59 years in nine China provinces is gradually Westernized. The energy supply ratios of carbohydrates and proteins primarily face issues of potential inadequacy, while the fat energy supply ratio is excessively high. Furthermore, the patterns of change vary among different occupational groups. It is recommended to propose personalized dietary advice tailored to specific occupations.

Chronic post-surgical pain (CPSP) is a common long-term complication following lung surgery. Its high incidence significantly impacts patients’ quality of life and functional recovery, and imposes a substantial socioeconomic burden. This consensus aims to systematically establish a standardized integrated Chinese and Western medicine diagnostic and treatment framework for chronic post-lung surgery pain (CPLSP). Based on the latest domestic and international evidence-based medical research and multidisciplinary clinical experience, the working group comprehensively elaborates on core issues regarding CPLSP, including its definition, epidemiology, pathogenesis, clinical assessment, Western medical treatment, traditional Chinese medicine (TCM) treatment, and integrated strategies. The consensus emphasizes a patient-centered approach, adhering to the principles of multimodality, individualization, and stepwise management, highlighting the synergistic advantages of integrating Chinese and Western medicine throughout the entire perioperative management cycle encompassing "perioperative anti-inflammation, acute analgesia, and chronic rehabilitation." Through systematic literature retrieval and evidence integration, a total of 9 core recommendations were established to provide scientifically sound and clinically practical guidance.

Objective: To analyze the associations of physical activity with overweight/obesity, depressive symptoms, and their co-occurrence among junior and senior high school students, so as to provide reference for optimizing physical activity intervention strategies and promoting healthy lifestyles. Methods: From March to November 2023, a cross sectional survey was conducted among 90 457 junior and senior high school students aged 11-18 years in Zhejiang Province using a stratified cluster random sampling method. Data on physical activity and dietary behavior were collected through questionnaires, height and weight were measured. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D). The Chi-square test was used to examine differences, and Logistic regression was applied to evaluate the associations of physical activity characteristics with overweight/obesity, depressive symptoms, and their co-occurrence. Additionally, the effectiveness of physical activity performed on rest days versus work days was examined. Results: The prevalence of overweight/obesity, depressive symptoms, and their co-occurrence among junior and senior high school students were 25.1%, 27.9%, and 6.7%, respectively, with significant sex differences ( χ 2=2 005.3, 587.7, 99.6, all P <0.01). Logistic regression analysis showed that students with insufficient physical activity had a higher risk of overweight/obesity compared with those with sufficient physical activity ( OR=1.12, 95%CI=1.06-1.17, P <0.01). Comparing to students who exercised 0-1 day per week, those who exercised 5-7 days per week were associated with a reduced risk of overweight/obesity and depressive symptoms ( OR=0.93, 95%CI =0.90-0.97; OR=0.95, 95%CI =0.91-0.99, both P <0.05). When total activity volume and frequency were held constant, students with sufficient rest day physical activity had lower risks of overweight/obesity, depressive symptoms, and their co-occurrence than those with insufficient rest day activity (all P < 0.01). Conclusions Sufficient amount of physical activity and higher frequency of rest day physical activity are significantly associated with lower risks of overweight/obesity, depressive symptoms, and their co-occurrence in adolescents. Physical activity performed on rest days may confer greater health benefits than activity performed on work days.

The surgical management of empyema (excluding those caused by mycobacterium tuberculosis and non-tuberculous mycobacteria) is rapidly evolving towards minimally invasive, precise, and stepwise approaches. The traditional three-stage classification (exudative, fibrinopurulent, and organizing) has limitations in guiding dynamic clinical decision-making. For the first time, this consensus explicitly identifies two critical junctures in the pathological progression of empyema: "early transformation" (stage Ⅰ to Ⅱ) and "late transformation" (stage Ⅱ to Ⅲ), and thereby constructs a corresponding "identification-early warning-intervention" stepwise therapeutic framework. The consensus emphasizes that proactive debridement via video-assisted thoracoscopic surgery should be performed during the early transformation phase to halt disease progression. Conversely, during the late transformation phase, therapeutic goals should be rationally adjusted to prioritize adequate drainage, avoiding futile pleural decortication. Moreover, the consensus underscores the pivotal role of precise perioperative etiological diagnosis (e.g. metagenomic nest-generation sequencing) and standardized anti-infective therapy. Integrating practical experiences from multiple thoracic surgery centers in China and relevant evidence-based literature, this consensus formulates recommendations on the precise definitions of staging, surgical indications for each phase, key technical points, perioperative management, and training systems. It aims to promote the standardized and individualized surgical management of empyema, ultimately optimizing patient prognosis.

Objective To investigate the risk factors for postoperative recurrence and metastasis in patients with T1 stageⅢ/Ⅳ clear cell renal cell carcinoma(ccRCC), and to analyze the influence of surgical methods on prognosis, so as to provide prognostic evaluation and treatment guidance for clinical practice. Methods A retrospective analysis was conducted on 398 patients diagnosed with T1 stage Ⅲ/Ⅳ ccRCC who underwent either partial nephrectomy(PN)or radical nephrectomy(RN)at Jiangsu Province Hospital during Jan. 2008 and Sep. 2022. The patients were divided into recurrence group(n=49)and non-recurrence group(n=349)according to whether the tumor recurred during the follow-up period. The general, clinical data and prognosis were compared between the two groups. Univariate and multivariate Cox regression analyses were used to explore the factors influencing disease-free survival(DFS)and overall survival(OS)after surgery. Subgroup analysis using Kaplan-Meier curves was performed for T1a and T1b patients. Results During the median follow-up of 67(42, 98)months, the recurrence group was characterized by older age, larger tumor diameter, higher proportion of T1b stage, and more complex tumor anatomy. Univariate and multivariate Cox regression analyses showed that age ≥55 years and R.E.N.A.L. score ≥7 were independent risk factors for poorer DFS and OS(P＜0.05). Subgroup analysis revealed that PN or RN did not significantly affect DFS or OS in T1a patients and OS in T1b patients, while RN significantly improved DFS in T1b patients(P＜0.05). Conclusion Age ≥55 years and R.E.N.A.L. score ≥7 are independent risk factors for poor DFS and OS in highgrade T1 ccRCC patients. For T1b patients, RN may improve DFS.

Objective To investigate whether glaucocalyxin A can reduce inflammatory response in rats with trau-matic fracture.Methods The rats were randomly divided into control group,model group,low GLA(GLA-L),high GLA dose group(GLA-H)and GLA?H+YC?1(HIF?1α inhibitor)group.The level of TNF?α,IL?6,CTX?Ⅰ,CTX?Ⅱ,S?Ca,S?P,BGP and the activities of iNOS and ALP were detected by ELISA.The density and thickness of bone trabeculae were measured by computed tomography.Apoptosis of femur tissue was detected by TUNEL.The cartilage morphology was observed by saffranin O?fast green staining.Western blot was applied to de?tect the expression of HIF?1α,VEGF,CD31,BMP?2,and collagenⅠ proteins in femoral tissue.Results Compared with the control group,the cartilage morphology of rats in the model group was significantly damaged,the level of serum TNF?α,IL?6,CTX?Ⅰ,CTX?Ⅱ,iNOS activity and apoptosis rate of femur tissue were in?creased.Serum S?Ca,S?P,BGP levels,ALP activity,bone trabecular density and thickness,HIF?1α,VEGF,CD31,BMP?2,collagen Ⅰ protein expression levels in femur tissue were all decreased(P<0.05).The mor?phology of cartilage tissue in GLA?L and GLA?H groups was significantly improved,and the level of serum TNF?α,IL?6,CTX?Ⅰ,CTX?Ⅱ,iNOS activity and apoptosis rate of femur tissue were all significantly de?creased.Serum levels of S?Ca,S?P,BGP,ALP activity,bone trabecular density and thickness,HIF?1α,VEGF,CD31,BMP?2,collagen Ⅰ protein expression level in femur tissue were significantly increased(P<0.05).YC?1 was able to weaken the therapeutic effect of GLA on traumatic fracture rats(P<0.05).Conclusions GLA alleviates inflammation and cartilage damage in rats with traumatic fractures,promotes angio?genesis and improves femoral morphology,possibly by activating the HIF?1α/VEGF signaling pathway.

Objective To explore the predictive value of albumin,hemoglobin and multifactorial model for poor postoperative prognosis in elderly patients with meningioma.Methods A retrospective analysis was conducted on 253 elderly patients who underwent meningioma surgery and were transferred to the neurosurgical intensive care unit(NICU)at General Hospital of Northern Theater Command from January 2019 to September 2021,serving as the modeling cohort.Another 227 elderly patients who were treated in NICU after meningioma surgery from November 2021 to June 2023 were used as the validation cohort.Patients in the modeling cohort were categorized into good prognosis group[Glasgow Coma Scale(GCS)score>7,n=161]and poor prognosis group(GCS≤7,n=92)based on the GCS.Univariate and multifactorial logistic regression analyses were performed on the modeling cohort to identify independent risk factors,and a multifactorial model for predicting poor postoperative prognosis in elderly patients with meningioma was constructed based on these factors.The predictive efficacy and accuracy of the model were evaluated using the area under the receiver operating characteristic(ROC)curve(AUC),sensitivity,specificity,Hosmer-Lemeshow goodness-of-fit test,and calibration curves.The predictive value of postoperative albumin,hemoglobin,and the multifactorial models for postoperative prognosis in elderly meningioma patients was assessed using restricted cubic spline modeling(RCS),decision curves(DCA),and validated using an external validation cohort to assess the stability of the model.Results Meningioma WHO grade Ⅱand Ⅲ(OR=3.994,95％CI 1.963-8.126),postoperative hypoalbuminemia(OR=2.194,95％CI 1.079-4.462),and postoperative anemia(OR=2.117,95％CI 1.096-4.089)were identified as independent risk factors for poor postoperative prognosis in elderly meningioma patients(P<0.05),while the use of analgesic/sedative medications was a protective factor(OR=0.388,95％CI 0.201-0.748,P<0.05).The Hosmer-Lemeshow test indicated that the constructed multifactorial model had a good fit accuracy(P=0.161).The AUC for predicting poor postoperative prognosis in elderly meningioma patients for postoperative albumin and hemoglobin were 0.545(95％CI 0.472-0.617)and 0.632(95％CI 0.561-0.702),respectively,and showed a nonlinear dose-response relationship with prognosis(P<0.01).DCA analysis results showed that the net benefit rate of multifactorial model was higher than that of postoperative albumin and hemoglobin when the threshold probabilities were between 0.10 and 0.90.The AUC for predicting postoperative prognosis in the elderly meningioma patients in the modeling and validation cohorts were 0.810 and 0.819,respectively,and their calibration curves suggested good discrimination and accuracy.Conclusions Meningioma WHO grades Ⅱ and Ⅲ,postoperative anemia and hypoalbuminemia are independent risk factors for poor postoperative prognosis in elderly meningioma patients,while the use of analgesic/sedative drugs is a protective factor.The multifactorial model constructed based on these factors has a good predictive efficacy and credibility,and can be used as a reference for clinical decision-making.

Objective:A nomogram model for predicting double positivity of microvascular invasion (MVI) and vascular endothelial-to-mesenchymal transition (VETC) in patients with hepatocellular carcinoma (HCC) was constructed and its predictive performance was evaluated.Methods:A retrospective analysis was conducted on 326 HCC patients who were treated at the Third People's Hospital of Nantong and the First Affiliated Hospital of Soochow University from January 2013 to June 2023, including 240 males and 86 females, with an average age of (58.7±9.0) years. The 326 patients were randomly divided into a training set ( n=228) and a test set ( n=98) at a ratio of 7: 3 using the random number table method. The training set was divided into a double-positive group ( n=54) and a control group ( n=174) based on whether the HCC patients were double positive for MVI and VETC. Univariate and multivariate logistic regression analyses were performed to identify the influencing factors of double positivity of microvascular invasion in HCC patients, and a nomogram for predicting double positivity of microvascular invasion patterns was constructed based on the multivariate. The predictive performance and clinical net benefit of the nomogram were evaluated using the receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis. Results:There were statistically significant differences in alpha-fetoprotein, gamma-glutamyl transferase, and phosphatidylinositol proteoglycan between the two groups (all P<0.05). Multivariate logistic regression analysis showed that LI-RADS category ( OR=8.58, 95% CI: 1.87-39.38), intratumoral hemorrhage ( OR=2.16, 95% CI: 1.14-4.07), and intratumoral arteries ( OR=2.59, 95% CI: 1.19-5.64) were all influencing factors of double positivity of microvascular invasion patterns in HCC patients (all P<0.05). Based on the multivariate results, a nomogram was constructed. In the training set, the area under the ROC curve for predicting double positivity of microvascular invasion patterns in HCC patients was 0.769 (95% CI: 0.720-0.814). In the test set, the area under the ROC curve for predicting double positivity of microvascular invasion patterns in HCC patients was 0.756 (95% CI: 0.622-0.850). The calibration curve showed a good fit between the predicted model and the ideal curve. Decision curve analysis showed that the clinical applicability was good when the threshold was 0.01-0.80 in the training set and 0.01-0.65 in the test set. Conclusion:The nomogram model based on LI-RADS category, intratumoral hemorrhage, and intratumoral arteries can effectively predict double positivity of microvascular invasion patterns in HCC patients and has good clinical applicability.

With the widespread application of information technology in the field of Traditional Chinese Medicine(TCM),the data in the TCM domain is becoming increasingly rich.The emergence of data-driven research in TCM has utilized knowledge graphs for the management,analysis,and presentation of TCM data,becoming a crucial method for the inheritance and innovation of Traditional Chinese Medicine.Therefore,reasoning based on TCM knowledge graphs has become a hot topic in contemporary TCM research.In order to better utilize knowledge graph reasoning technology to promote innovation and development in TCM,this article,after providing an overview of TCM knowledge graph reasoning,focuses on the development of knowledge graph reasoning in TCM and its applications from three perspectives:logic rule-based,distributed representation,and neural network-based methods.Finally,the article summarizes the advantages and disadvantages of knowledge reasoning methods and provides prospects for research and applications in TCM knowledge graph reasoning,including studies on interpretability,temporal knowledge graphs,and the fusion of multimodal information.

Objective:To analyze the effect of long noncoding RNA (lncRNA) small nucleolar RNA host gene 16 (SNHG16) on the radiosensitivity of cervical cancer cells and explore its regulatory role in the miR-455-3p/ nuclear factor-κB (NF-κB) signaling pathway.Methods:The expression levels of lncRNA SNHG16 and miR-455-3p in human normal cervical epithelial cells H8, human cervical cancer cells SiHa, and radioresistant cervical cancer cells SiHa-R were detected by real-time reverse transcription polymerase chain reaction. SiHa-R cells were transfected separately, and then given a single dose of 4 Gy X-ray irradiation and continued to be cultured for subsequent experiments. The cells in each group were named siRNA-NC, siRNA-SNHG16 (interfering lncRNA SNHG16), NC mimic, miR-455-3p mimic (overexpressing miR-455-3p), siRNA-SNHG16+inhibitor NC, and siRNA-SNHG16+miR-455-3p inhibitor groups, respectively. The survival fraction of SiHa-R cells was detected by clone formation assay. The apoptosis rate of SiHa-R cells was analyzed by flow cytometry. The expression levels of apoptotic proteins [cysteine-containing aspartate-specific protease (Caspase)-3, Caspase-9, Bax] and NF-κB signaling pathway related proteins [NF-κB p65, phosphorylated (p)-NF-κB p65, p-IκB (inhibitory protein of NF-κB)] were measured by Western blot. The targeting relationship between lncRNA SNHG16 and miR-455-3p was determined by dual luciferase reporter gene assay. Comparison among different groups was conducted by one-way ANOVA, and paired comparison was carried out by LSD t-test. Comparison between two groups was performed by t-test. Results:Compared with H8 cells, the expression levels of lncRNA SNHG16 were increased in SiHa and SiHa-R cells, and SiHa-R cells had a higher level than SiHa cells. The expression levels of miR-455-3p were decreased in SiHa and SiHa-R cells, and SiHa-R cells had a lower level than SiHa cells (all P<0.001). Compared with the siRNA-NC group, the survival fraction of SiHa-R cells in the siRNA-SNHG16 group was decreased, the radiosensitization ratio (SER) was 1.571 (>1), the apoptosis rate and levels of Caspase-3, Caspase-9, and Bax proteins were increased, while the levels of p-NF-κB p65 and p-IκB proteins were decreased (all P<0.001). lncRNA SNHG16 could target miR-455-3p. Compared with the NC mimic group, miR-455-3p level in the miR-455-3p mimic group was increased, cell survival fraction was decreased, the SER was 1.826 (>1), the apoptosis rate and the levels of Caspase-3, Caspase-9, Bax proteins were increased, and the levels of p-NF-κB p65 and p-IκB proteins were decreased (all P<0.001). Inhibition of miR-455-3p expression could weaken the effect of interfering with lncRNA SNHG16 expression on SiHa-R cell apoptosis, radiotherapy sensitivity, and NF-κB signaling pathway (all P<0.001). Conclusions:Interference with lncRNA SNHG16 expression could induce the apoptosis of cervical cancer cells and enhance their radiation sensitivity by regulating the miR-455-3p/NF-κB signaling pathway.